APPENDIX D. 

 Report Form and Information Sheet 



DUE BY FEBRUARY 1. 19B8 



OMBNo 06Q7-053A Approv»l txpHaa Soplcmoer 30 T989 



• 87-A0201 



as CENSUS USA. 



UNITED STATES 



CENSUS 

 OF AGRICULTURE 



BUREAU OF THE CENSUS 

 1201 East Tenth Street 

 JaHarsonville, IN 47133 



Note If yout records are not available, reasonable estimates may be 

 used. t( you cannot ftle by Febmary 1. a time extension request may be 

 sent to the above address. Include your 12-character Census File 

 Number (CFN) as shown in your address label in all correspondence to 



If you recerved mofe tfian one 

 repon form, enler extra 

 Census File Numberls) here 

 and return extra copies with 

 vour completed report 



CENSUS 



USE 



ONLY 



NOTICE - Response to this inquiry is required by law (title 13, U.S. Code). By the sanie law YOUR REPORT TO 

 THE CENSUS BUREAU IS CONFIDENTIAL. It may be seen only by sworn Cerisus employees and may bo used 

 only lor statistical purposes Your report CANNOT be used lor purposes ol taxation, investigation, or regulation. 

 The law also provides that copies retained in your files are immune from legal process. 



In corraspondefftca pertaining to this raport, plaasa rafar to your Cansus Flla Number (CFN) 



87-A0201 



r 



Please correct errors in name, address, and ZIP Code ENTER streor and number if not shown. 



?graft'J|iKTOa ACREAGE IM 1987 Report land owned, rented, or used 

 g, by you, your spouse, or by the partnership, corporation, or 

 organization for which you are reporting. Include ALL LAND, 

 REGARDLESS OF LOCATION OR USE - cropland, 

 pastureland. rangeland, woodland, idle land, house lots, etc. 



It the acres you operated in 1387 changed during the year, 

 refer to the INFORMATION SHEET, aection 1. 



1 . All land owned LJ 



2 . All land rented or leased FROM OTHERS, including land worked 

 by you on shares, used rent free, in exchange tor services, 

 payment of taxes, etc. Include leased Federal, State, and railroad 

 land. (DO NOT include land used on a per-head basis under a 

 grazing permit.) Also complete item 5 below Li 



3 . All land rented or leased TO OTHERS, including land worked on 

 shares by others and land subleased. Also complete nem 6 below, LJ 



4 . Acres in "THIS PLACE" — add acres owned (item 1 ) 

 and acres rented (item 2), then SUBTRACT acres rented 



TO OTHERS (item 3), and enter the result in this space ^ 



Number of acres 



^ 046 



For this consua report those are the acrsa m "THIS PLACE, "- 



If The entry is zero please refer to the INFORM A TION SHEET, section 1 . 

 5 . If you rented land FROM OTHERS (item 2\ , enter the following (nformatlon for each laridlord. 



Name of landlord 



Mailing address (Include ZIP Code) 



Number of acres 



Ust additional landlords on a separate sheet of paper. 



6. H you rented land TO OTHERS (item 3), enter the following information for each renter. 



Name of renter 



Mailing address (Include ZIP Code) 



Number of acres 



List additional renters on a separate stieet of paper. 



a. Of the land you rented or teased to others, how many oss 



acres did you own? LJ - 



Acres 



7. Did you have any grazing permits on a per-head basis? 



064 / 3 LJ Forest Service 



1 □ Yes - Mark (X) all boxes which apply . . J " Q "^^Vlor Grazing Sec. 3 (BLM) 



2 I I No — Go to nem 8 



.n 



Indian Land 



3 dl Other - Specify^ 



8. LOCATION OF AGRICULTURAL ACTlVrTY FOR "THIS PLACE" 



a . In what county was the 



INSTRUCTIONS — Please report your crops in the appropriate section. 



Use secrtlon 7 to report ONLY those CROPS NOT listed in sections 2 through 6 



and section 8. DO NOT INCLUDE crops grown on land rented to others. 



iJTr»lt»tT7K>:J Wi»w. any q< thu foflowlrto CROPS harvested ffrotn 'THIS PLACE'' 

 in 1987? 



1 . Com (field) for grain or 



seed (Report QuanTrtY on a 

 dry shelled weight basis.) . . 



2. Com (field) for silage 



or green chop 



n 



D 

 D 



n 

 n 



3. Soybeans for beans 



4. Beans, dry edible . . 



5. Wheat for grain . . . 



6. Oats for grain D 



7. Barley for grain □ 



8. Rye for gram LJ 



9. Sorghum for grain 



or seed D 



10. Sorghum for silage or 



green chop rOo nor incftAte . — . 



sorghum-sudan crosses.) . . . 1 ! 



1 1 . Tobacco — all types . . D 



12. Potatoes, Irish tJ 



Acres 



harvested 



no 



Quantity harvested 



Tons, 

 grean 



07G 



078 



Acres 

 irrigated 



i4.-^jAilti'bctel Wnn any PRY HAY. GRASS SILAGE. HAYLAGE. Of GREEN CHOP c 

 or harvested from "THIS PLACE" in 1 987? 

 tncluda sorghuwn-audan crosses and hay ci#f from pastures. 



^^ 1 LJ YES — Complmf thim m0Ctlon 2 D NO ^ Go to section 4 



If cuttings were made for both dry hay and grass silage, haylage, or green chop 



from the same fields, report the acreage in the appropnate items under DRY 



HA Y and also under GRASS SILAGE, HA YLACE. and GREEN CHOP. 



1 . DRY HAY (If two or more cuttings of dry 

 hay were made from the same acres, report 

 acres only once, but report total tons from all 

 cuttings.) 



a. Alfalfa and alfalfa mixtures for 



hay or dehydrating 



b. Small grain hay — oats, wheat, 

 barley, rye, etc 



c.Other tame dry hay — clovei, lespedeza. 

 timothy, Sudangrass, meadow and 

 pasture grasses, etc 



largest value ot your 

 agricultural products 

 raised or produced? . , . . 



b. If you also had agricultural 

 operations in any other 

 county(ies|, enter the 

 county name(s), etc 



Principal 

 county—^ 



Othei 

 counties 



County name 



Number of acres 



d. Wild hay 



2 . GRASS SILAGE, HAYLAGE, AND 



GREEN CHOP (if two or more cuttings 

 were made from the same acres, report 

 Bcres only once, but report total tons from 

 all cuttings, i 



3. HAY SOLD — Did you sell any hay 

 or grass silage in 1987? Weporr value 



of hay sold in section 3. item 3} 



Acres 

 narvested 



Quantity 

 harvested 



(Beport Btther dry 

 Of graan weight 3S 

 indicatedl 



Tons, 

 dry 



Tons, 

 dry 



Acres 

 irrigated 



. n Yes 



!□ No 



PENALTY FOR FAILURE TO REPORT 



1987 CENSUS OF AGRICULTURE 



APPENDIX D 0-1 



